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I have direct knowledge of an ophthalmologist splitting surgeries over two days that could have been done in one session, because it nearly doubles their billin

by leot 7y ago

I have direct knowledge of an ophthalmologist splitting surgeries over two days that could have been done in one session, because it nearly doubles their billings. They justify it by pointing at their less educated yet better-compensated college buddies working in finance. I've seen similar bad money-optimizing behavior from PCPs (e.g. it was insisted to me that I schedule an appt for lab results, which was justified by a lie about HIPAA preventing me from being able to get them over the phone). The rot goes deep.

riahi 7y ago
Or you could not have insurance play games where they pay less because something is done on the same day. We used to have this in Radiology. If a patient came in for a Cancer restaging CT, payers could pay 100% of the chest, 50% of the abdomen, and 25% of the pelvis. Just because these were done on the same day doesn't mean it's any faster or cheaper to interpret each of those portions. Yes there's some savings in the technical components (placing the IV etc), but it takes me just as long to read the three scans if they are done on one day or 3. Why should I take a 125% hit when I'm providing a convenience for the patient by doing all their scans on the same day?
- ikiris 7y ago
  The entitlement in this single post is staggering. You are part of the problem.
- Alkim 7y ago
  "Why should I take a 125% hit when I'm providing a convenience for the patient by doing all their scans on the same day?" You don't see what is wrong here? If your mechanic told you he wanted you to come to the shop 3 times instead of one for his convenience, you would find another mechanic. I'm from the US and I've lived in Singapore and the UAE for many years. And I've had to deal with the US system from time to time as well. Medical services cost a fraction in Asia and the Middle East compared to the US and the paperwork is much simpler. And most of the doctors are educated in Europe. And lately I've seen more US doctors moving abroad simply out of frustration. One time I was in West Virginia with my family and I had trouble catching my breath so we went to the ER. 1.5 hours of waiting, literally a 5 minute visit from the ER doctor and a 3600 USD bill. No treatment. No meds. Later I had to negotiate with the hospital over the bill. Eventually they told me that the insurance reimbursement rate for my vist would have been 600 bucks, but because I had no insurance, I was expected to pay 3600. I eventually got it down to 2200 after much angst and effort. Sick people don't need this aggro. Nor do they need the pain and discomfort for visiting the medical facility 3 times instead of 1 because of the vagaries of the US insurance/hospital billing system. The US system is broken.
- gnaritas 7y ago
  > Why should I take a 125% hit when I'm providing a convenience for the patient by doing all their scans on the same day? Because what you're doing otherwise is unethical. Padding the bill by spreading out the appointments is a form of theft.
- leot 7y ago
  You realize that the physician could have done both eyes in the same sitting, and then used the saved time to perform a procedure for someone else, right? Doing so would have been better for everyone, rather than riskier and much less convenient for the patient.

by leot 7y ago

riahi 7y ago

Or you could not have insurance play games where they pay less because something is done on the same day. We used to have this in Radiology. If a patient came in for a Cancer restaging CT, payers could pay 100% of the chest, 50% of the abdomen, and 25% of the pelvis. Just because these were done on the same day doesn't mean it's any faster or cheaper to interpret each of those portions. Yes there's some savings in the technical components (placing the IV etc), but it takes me just as long to read the three scans if they are done on one day or 3. Why should I take a 125% hit when I'm providing a convenience for the patient by doing all their scans on the same day?

ikiris 7y ago
The entitlement in this single post is staggering. You are part of the problem.
Alkim 7y ago
"Why should I take a 125% hit when I'm providing a convenience for the patient by doing all their scans on the same day?" You don't see what is wrong here? If your mechanic told you he wanted you to come to the shop 3 times instead of one for his convenience, you would find another mechanic. I'm from the US and I've lived in Singapore and the UAE for many years. And I've had to deal with the US system from time to time as well. Medical services cost a fraction in Asia and the Middle East compared to the US and the paperwork is much simpler. And most of the doctors are educated in Europe. And lately I've seen more US doctors moving abroad simply out of frustration. One time I was in West Virginia with my family and I had trouble catching my breath so we went to the ER. 1.5 hours of waiting, literally a 5 minute visit from the ER doctor and a 3600 USD bill. No treatment. No meds. Later I had to negotiate with the hospital over the bill. Eventually they told me that the insurance reimbursement rate for my vist would have been 600 bucks, but because I had no insurance, I was expected to pay 3600. I eventually got it down to 2200 after much angst and effort. Sick people don't need this aggro. Nor do they need the pain and discomfort for visiting the medical facility 3 times instead of 1 because of the vagaries of the US insurance/hospital billing system. The US system is broken.
gnaritas 7y ago
> Why should I take a 125% hit when I'm providing a convenience for the patient by doing all their scans on the same day? Because what you're doing otherwise is unethical. Padding the bill by spreading out the appointments is a form of theft.
leot 7y ago
You realize that the physician could have done both eyes in the same sitting, and then used the saved time to perform a procedure for someone else, right? Doing so would have been better for everyone, rather than riskier and much less convenient for the patient.